Personally, I never had to have a therapist's letter to get hormones. I went to a trans-friendly doctor, told her I wanted T, and based upon the fact I'd been full-time for over a year, she ran a few medical tests, got the results back, and put me on T right away.
I have a feeling if you see a doctor who deals typically with trans issues, it should be easy enough for them to prescribe the hormones simply based on the fact you've been living as a male for so long (or so I assume). Of course, I was in California when I was first prescribed T, and I know Ohio can be far more conservative at times (I was born there, and considering it's one of only 4 states where you can't legally change the sex on your birth certificate, it's gotta be pretty messed up). Good luck, man.
SD